Image-Guided Percutaneous Pancreatic Duct Drainage: A 10-Year Observational Study.

PURPOSE: To study the safety, efficacy, and long-term outcomes of percutaneous pancreatic duct drainage (PPDD) for treating pancreatic duct (PD) obstruction.

MATERIALS AND METHODS: This prospective observational cohort study included 73 patients with PD obstruction between December 2010 and June 2020. Patients underwent PPDD under ultrasound and fluoroscopy guidance, computed tomography (CT) and fluoroscopy guidance, or CT guidance only. They were categorized into two groups: nonmalignant (26 patients with PD obstruction due to acute and chronic pancreatitis or postoperative stricture) and malignant (47 patients with pancreatic head and ampullary tumors).

RESULTS: Overall technical success rate was 98.6% (72/73). No major complications were encountered; however, severe weakness, lack of appetite, and tachycardia were observed in 4.1% (3/73) of patients managed with intravenous resuscitation. Multivariate analysis demonstrated that diagnosis type (pancreatic head tumor: P = .049 and odds ratio = 1.95 [1.11-2.25] and chronic pancreatitis: P = .048 and odds ratio = 6.25 [1.74-22.22]) were associated with mortality. The median survival time was 16.3 months. Moreover, 15.1% (11/73) of the patients were alive 4 years after the PPDD procedure, and the mean overall survival time of nonmalignant and malignant patients was 35.1 and 21.4 months, respectively.

CONCLUSIONS: Image-guided PPDD appears to be feasible and safe, and provides a valuable therapeutic option for managing patients with PD obstruction.